Nursing Students Help Homeless Center Clients Care for Feet

Photo by Heidi Stambuck

Nursing students Emily Kitzmiller, left, and Caroline Dillon check supplies in the foot care clinic.

The weather outside was cold and blustery but University of Arkansas nursing students welcomed clients of 7hills Homeless Day Center into their foot care clinic to soak their feet in a plastic basin of warm, sudsy water.

The seniors preparing to graduate in May from the Eleanor Mann School of Nursing chose to work with the facility in Fayetteville serving the homeless as part of their class on community-based health care. They held their second foot care clinic on Feb. 24.

Carol Agana, instructor of nursing, teaches the course, which requires students to spend 120 hours in a community setting. Small groups of students taking the course are supervised in a clinical setting by adjunct clinical instructors. The work at 7hills is a pilot project the nursing school developed to focus on a population of people, rather than a specific site, Agana said.

"We're getting the bigger picture of an entire population, whether it's pregnant teens in high school, women living in women's shelter, incarcerated women or parents of disabled children," she said. "I left it up to each clinical faculty member to see what their particular interest is and what their students are interested in."

The 7hills day center serves about 100 clients per day, said Melissa Moon, program director. Services include case management, food pantry, clothing, meals, showers, computer use and a mailing address.

"Our partnership with the nursing school is a true win-win opportunity," Moon said. "The day center offers an excellent learning environment for students, and our clients definitely benefit from interacting with the students. Clients are grateful to have someone to talk to about health concerns, and, frankly, just to be in the presence of someone who genuinely cares about their well-being."

Janet Gardner supervises the students in the 7hills clinical setting. She said the students began by assessing needs of the people who come to the 7hills facility.

"I did some research prior to starting the clinical last semester through information published about the health risks and problems that homeless people face," Gardner said. "Foot care was always mentioned because this is the primary form of transportation for many of these people. Once we began coming to 7hills, the students talked to the staff members as well as the clients to identify areas they would like us to address."

Foot care was one area, along with increasing access to health care in general.

"With the homeless population, we are doing basic screenings and medication teaching, helping them find access to health care other than the emergency room, and hoping to make sure they have healthy feet, to name a few," she said. "We have also educated them about different health risks. Last week, we talked to a young mom about how cigarette smoke could affect her baby through the environment and breastfeeding."

While the main goal of this clinical experience is to learn about and meet the needs of the homeless community, Gardner said, another goal is to open the eyes of nursing students about populations they don't usually encounter.

"After this first rotation of students through 7hills, all of the students said this is an experience they will carry with them throughout their careers," she said. "They have been exposed to an example of how they can serve their communities in the future with the special skills they will have as a nurse."

The experience has been life-changing, Gardner said.

"The relationships the students made with the clients were amazing," she said. "The clients opened up as the weeks went on, and I think this will continue with the next groups. Through us consistently being a presence at 7hills, we are gaining trust with the clients, and they are becoming more comfortable asking us to help them."

The nursing students conduct the foot care clinic in one building on the grounds, taking clients into a small room to soak their feet before the students examine them. Student Caroline Dillon said they learned about foot care early in their time as nursing students.

"After their feet are washed, we assess them for wounds or other infections," Dillon said. "We talk about any problems they may have."

People with diabetes need to be especially careful because their wounds are slower to heal and more likely to become infected, Dillon said.

Reagan Shivitz, another nursing student, said feet are an important part of the body.

"Homeless people are often on their feet most of the day, and they wear their shoes all day long," she said. "We tell them to check their feet every day."

Local running stores Rush Running and Fleet Feet helped collect shoes during a drive early in the semester, and the students also collected donations of money and supplies from local pharmacies and other stores. Greek organizations on campus assisted with the shoe drive.

Students sorted the shoes into packages by size, and clients sign up in advance for the foot clinic, filling out a form that includes listing their shoe size. The bags also contain socks and foot powder.

In another building on the grounds, other nursing students check clients' blood pressure and blood glucose levels.

Dillon said the reception from clients at the center has been very warm.

"When they come in the morning, the first thing they ask is if the nurses are here," she said.